LB 3405 
.L73 
1886 
Copy 1 



k 2 



The Sanitary Conditions and 
Necessities of School-Houses 



and School-Life. 






American public jSjealtl) ^00oriatton 



LOMB PRIZE ESSAY 



THE SANITARY CONDITIONS AND NECES- 
SITIES OF SCHOOL-HOUSES AND 
SCHOOL LIFE 



By D. F. LINCOLN, M. D. 

BmfoK, Mass. 



, 



"Tl 



MARS 2 \%%% ^» 

NEW YORK. 

- — SJ 

■ ".in m ,„.l 



€omaxb t it. 0. 

Republican Press Association, 22 North Main Street 
1886 



Copyright, 1886, 
By Irving A. Watson, Sec. American Public Health Association. 



All Rights Reserved. 



PIEW YORK POBL, UBK. 
IN EXCHAN-^ 

JUL 7 1905 



INTRODUCTION. 



As the result of prizes offered by Mr. Henry Lomb, of Rochester, 
N. Y.j through the American Public Health Association, the following 
awards were made at the last meeting of the association : 

I. Healthy Homes and Foods for the Working Classes. By Victor C. 

Vaughan, M. D., Ph. D., Professor in University of Michigan. Prize, . . $200 
II. The Sanitary Conditions and Necessities of School-Houses and 

School-Life. By D. F. Lincoln, M. D., Boston, Mass. Prize, . . . $200 

III. Disinfection and Individual Prophylaxis against Infectious Dis- 

eases. By George M. Sternberg, M. D., Major and Surgeon U. S. Army. 
Prize, . . ' $500 

IV. The Preventable Causes of Disease, Injury, and Death in American 

Manufactories and Workshops, and the Best Means and Appli- 
ances for Preventing and Avoiding them. By George H. Ireland, 
Springfield, Mass. Prize, $200 

That these essays may be placed in the hands of every family in the 
country is the earnest desire of the association, as well as the heartfelt 
wish of the public-spirited and philanthropic citizen whose unpretentious 
generosity and unselfish devotion. to the interests of humanity have given 
us these essays, but the financial inability of the association renders it 
impossible to distribute them gratuitously ; — therefore a price covering 
the cost has been placed upon these publications. It is to be hoped, 
however, that government departments, state and local boai-ds of health, 
sanitary and benevolent associations, etc., will either publish these essays, 
or purchase editions at cost of the association, for distribution among the 
people. 

Although a copyright has been placed upon these essays for legitimate 
protection, permission to publish, under certain conditions, can be ob- 
tained by addressing the secretary. 



¥ 



The Sanitary Conditions and Necessities of School- 
Houses and School-Life. 



COMMITTEE OF AWARD. 

Hon. Erastus Brooks, member State Board of Health, New York. 

Dr. Henry P. Walcott, President State Board of Health, Massa- 
chusetts. 

Dr. Granville P. Conn, President State Board of Health, New 
Hampshire. 

Hon. John Eaton, Commissioner of Education, Washington, D. C. 
Col. George E. Waring, Jr., C. E., Newport, R. I. 



SCHOOL HYGIENE. 



INTRODUCTORY. 



Two men should be mentioned at the head of an essay of this sort, as 
deserving to represent the beginning of the "movement" in school 
hygiene. They are Cohn of Breslau, whose examinations of the eyes of 
school-children made a very powerful impression on the public mind 
some sixteen years ago, and Virchow, whose official report to the Prus- 
sian minister of education (published in 1869), is the most prominent 
document that can be referred to as leading the way in reform. 

It is not intended in this essay to quote largely from German authori- 
ties. The mere statement of principles and facts must suffice in so wide 
and manifold a subject as the present. 

It should be noted that Virchow makes use of the expression " school- 
diseases." He is probably entitled to the credit of inventing the word. In 
the list which he gives there is one affection which we need not dwell 
upon, namely, nose-bleed. In regard to another, — tubercular consump- 
tion, — there is perhaps a deficiency of evidence as to its causation in 
schools in America, though there can be no reasonable doubt that it is 
so caused, and the writer has the highest American authority for saying so. 

Deformity of the spine (lateral curvature) is probably not so common 
by a good deal in America as Gnillaume represents it in Switzerland. 
We lack decided evidence ; but it is spoken of under the proper heads in 
this essay. 

It remains to note the division of the subject which has been followed, 
viz. : 

1. Site of the School-House. 

2. Plan and Arrangement of the Building. 

3. Ventilation and Heating. 

4. Sewerage. 

5. Hygiene of the Eye. 

6. School-Desks and Gymnastics. 

7. Affections of the Nervous System. 

8. Contagious Disease. 

9. Sanitary Supervision. 



In choosing the site for a school-building, we should take into account 
a number of things which might be overlooked in the case of an ordinary 
building. Dampness and malaria are of course fatal to a site for anv 
purpose. For schools we must plan to have abundant light (much more 
than will suffice for dwellings and shops) , and to have the sun's direct 



6 SCHOOL HYGIENE. 

rays enter each room at some time of the day. The business of the 
school requires the absence of noise, — a point which may be overlooked 
in business edifices ; and the social character of the neighborhood, and 
its moral nuisances, are also to be considered. 

Dampness. Without going much into details, the use of some method 
of drainage and of some shield against incoming water is suggested, as 
likely to be needed in many places. The cellar, as hygienists know, 
ought to be carefully guarded f'om contamination of soil and air, and 
should at all times be dry. Grading will suffice to keep off most of the 
surface water. Undergi'ound water may be provided for by a ditch, dug 
outside of the foundation and reaching deeper than the cellar floor, and 
either laid- with drain tile, or filled to the depth of a foot with loose 
stones, after which earth is thrown in. A similar trench may be cut in 
the floor. All such drains are to be led to a proper place for discharge. 
The. floor may be made damp-proof, according to Col. Waring's sugges- 
tion, by six inches of well rammed clay, or by asphalt between two layers 
of cement ; the foundation walls may be protected by a coating of asphalt 
outside. A damp-proof course of asphalt in the walls above the ground 
is useful in preventing moisture from rising. 

Small country schools, if without a cellar, should at least have an atr- 
space underneath the floor, with a few openings in the underpinning, to 
give ventilation to the space. 

River bottoms, places where mist is often seen, and the neighborhood 
of ponds, are undesirable places for building. No business is more inter- 
fered with by noise than that of school. The neighborhood of large fac- 
tories, saw-mills, foundries, railway stations, engine-houses, or police 
stations, is therefore to be avoided. There need be no excuse for placing 
a school-house near any such of the latter as are under public control, or 
for utilizing a town lot by putting engine-houses, school-houses, and a 
police station, in close neighborhood. Regard ought to be had for the 
probable growth of a city, and avenues likely to become main lines of 
travel should be avoided. These things are mentioned because they are 
sometimes strangely disregarded. In large cities it is next to impossible 
to procure sites which fully satisfy the demand of hygiene in respect to 
the supply of light. Corner lots are enormously expensive, besides being 
noisy. The Sanitary Engineer prize designs for public schools, pub- 
lished in 1880, are instructive as showing that in the opinion of the prize 
committee, — 

" The most essential thing in a public school is sufficient light. The 
conditions imposed in this competition make it impossible to secure this 
light without either overcrowding of class-rooms, or an unsatisfactory 
arrangement of corridors, stairs, etc." 

"Upon so restricted a site as that contemplated 1 , light can best be 
secured by making the building very high, higher than for other reasons 
is desirable. 

!"A lot fronting north, of 100 feet front and 100 deep, and enclosed by buildings on adjoining lots 
at the sides and rear, of average city height, say four stories." (Advertisement.) 



SCHOOL HYGIENE. 7 

" It should be distinctly understood that the committee do not recom- 
mend the plans to which they have given awards as being the best 
designs for a school building, but only as the best plans for a school 
building to be built in a huge box, lacking one side and without a top, 
the sides of which box are about sixty feet high, which seem to be the 
conditions under which school buildings have been erected in New York, 
and in which from 1,500 to 2,500 children have been crowded." — (San. 
Engineer, March 1, 18S0.) 

The evil complained of is a general one. New York is not the only 
city where fine new school buildings are erected, with a pleasant outlook 
all around, only to have four-story houses placed on both sides, within a 
dozen feet of their windows, in the course of a year or two. This is one 
of the worst failings of city schools. 



Fig. 1. 













Stairs 


\ 


Class 


Class 


Class 










Class 


Class 


Clothes 


Clas 


y 


Class 



Plan of School-house illustrating excessive 
compactness. 



II. PLAN AND ARRANGEMENT. 

Many of our oldest school buildings are extremely faulty. In fact, we 
have seen two reformations in school architecture, one dating from the 

publication of Henry Bar- 
nard's work, in 1839, while 
the other is now taking 
place. T he progress made 
within a few years past has 
been as great as at any 
other period, and types of 
edifices, which were un- 
challenged models of ex- 
cellence fifteen years ago, 
are now superseded. 

In schools containing 
several rooms, one of the 
commonest faults used to 
be the parsimony of space, which cut down the room for entries to a min- 
imum, and packed class-room behind class-room without breathing space. 
The effect of this was 
greatly to restrict nat- 
ural ventilation. Glass 
sliding doors Were very 
popular : it may be 
feared that they still are 
in some places. Spiral 
stairs were admired. 
Architectural features, 
such as colonnades and 
heavy Greek entabla- 
tures, are still seen on 
some older buildings, Plan — Same fault. 

the former serving to cut off a certain part of the light, the latter taking 



Fig. 2. 





j 

Corridor and Stairs 




Fire 


Class 


Rooms 





8 



SCHOOL HYGIENE. 



Stairs 

etc. 



SI 



CLA 



RO 



X 



ss 



QMS 



Class 
Room 



Stairs 

etc. 



Directors 1 
Room 



Lobby and Stairs 



up space in the wall which ought to be devoted to windows. Excessive 
height is a fault which is only just beginning to be remedied. It arises 

partly from a false taste in archi- 
tectuie, partly from the expensive- 
ness of land in cities. 

An instance of the excessively 
compact style of building is given 
in the illustrations (Figs, i and 2), 
which are taken from the Report 
of the New York State Board of 
Health for 1S81 ; also in Fig. 3. 
Glass sliding doors are sup- 
Fi*. ?. P ose d to assist in lighting rooms 
which are faultily lighted in other 
respects. They are far less effect- 
ual than is thought. A person 
standing in the inner room looks 
out through the glass doors upon 
well lighted rooms, and thinks the 
light he sees is entering the room 
where he stands — a false impres- 
sion, which should be corrected 
by looking the other way. Light 
thus transmitted is nearly horizon- 
tal in direction, and has very little 
Plan of School. Philadelphia. effect in brightening the page of a 

a book lying on a desk. Glass also reflects some light, and absorbs 
some. In short, light thus obtained is not good light for the purposes 
of study. The rooms in Fig. 3 have glass partitions. 

Another common fault in plan is to have one of the rooms of such 
dimensions that it is impossible to light it advantageously. Such very 
large rooms form an essential part of many high schools, even of modern 
construction ; they are used as rooms of assembly, and also as the gen- 
eral study rooms, each pupil having a desk there, and only leaving it as 
occasion offers to go to small recitation-rooms. Such rooms are usually 
lighted from the right and left sides. The width between the windows 
is sometimes as great as seventy feet. The great distance of the windows 
from the central parts of the room is a marked disadvantage. Twenty or 
twenty-five feet is as far as a desk ought to be from the window. 

Associated with this fault, — or independently, — may be found a defi- 
ciency in the size of recitation-rooms. It seems to be supposed that 
these places do not require as much space as ordinary class-rooms, the 
fact being, that they are apt to be in use about all the time, and therefore 
are in no way to be excepted from strict requirements. When looking 
for instances of bad ventilation and overcrowding, one should not omit to 
visit these rooms. The allowance of cubic space for each scholar will be 
mentioned later. 



SCHOOL HYGIENE. 



A type still in vogue, which has some decided merits, may be called 
the four-square plan. It contains, on each floor, four rooms and a corri- 
dor : the corridor runs from front to rear, and the rooms are in pairs to 

right and left. There is a stair- 
case in front and rear. Each room 
is lighted from one side and the 
rear of the scholars : each room 
is a corner room. The type 
which is likely to supersede this 
one is based on the wish to give 
more light and ventilation in the 
corridors. Both are illustrated 
(Figs. 4 and 5). It would be 
rash, however, to point to any 
one plan as likely to have exclu- 
■Fig. 4- sive success. 

The objection to spiral stairs is, that the tread is very narrow on the side 
next the wall, and a careless person easily gets a severe fall. The tread 
should never be wedge-shaped. It is a good plan to break up a flight of 
stairs by placing a landing half-way, with a full turn. Both stairs and 
corridors must be well lighted. The steps must be easf to ascend. 

It is desirable to build stairways as nearly fire-proof as possible. They 
may be enclosed in brick walls, so that fire from the main edifice will 
reach them with difficulty. One staircase should be placed at each end 
of the building, so that no room need be cut off by smoke or flame at the 







1 i_ 










Stairs 














Stairs 

1_ _ 























Stairs 


Office 


Stairs j 




outbreak of fire : it will be easy to go a step further, and place them out- 
side, or partly outside, of the building, for more complete isolation. If 
the framework is of iron, the treads may be of hard wood, which makes 
them for all practical puposes fire-proof. 

These precautions are among the first to be taken against fire — we 
might say against panic, for the danger to life from fire, in a school 
where children are orderly, is scarcely to be thought of. A thousand 
children can be got out of a large school within two minutes of an alarm 



10 SCHOOL HYGIENE. 

from the principal. They say it can be done in less time ; it depends, 
however, on having the children exercised in a special " fire-drill," the 
sole object of which is to pass them out as quickly as possible. In the 
best schools this drill is given ■without warning once a month. 

Further precautions against fire may be taken : they ought not to be 
limited, however, to prevention of combustion, but should include some 
means for carrying off smoke, which is so apt to cause panic. To this 
end, it is proposed, by the chief engineer of one of our large cities, to 
have a large valve, easily opened, at the roof, so as to draw out great quan- 
tities of air or smoke. There may be also extra flues, built in the parti- 
tion walls, communicating with such floor spaces or wainscot spaces as 
may be supposed likely to be the seat of fire. The flues will not afford a 
supply of air to the flame, but will only carry off the smoke and gases 
instead of letting them come through the floors. The writer does not ex- 
press an opinion upon these suggestions, but they rest on good authority. 
Fire-proofing beneath the floors with layers of plaster is certainly to be 
recommended ; also, the practice of bringing the floors close up to the 
walls, thus cutting off the connection between story and story, which is 
so often the means of transmitting a fire with surprising rapidity to the 
upper stories. Perhaps the chief benefit of all these precautions, as 
regards safety of person, lies in the feeling of security against sudden 
conflagi-ation, which will give confidence in the moment of alarm to some 
teachers who might otherwise be overpowered by sudden dread. 

There are some buildings in most cities which were never meant for 
schools, but which are crowded with poor children, whose danger would 
be imminent in case of fire. A so-called fire-escape, placed on one of 
these wooden traps, affords a possible means of safety, but, for the most 
part, a good staircase in a well built school-house is the best " fire-escape." 

The passages to be passed through by the scholars in reaching the door 
should be wide ; the outer doors should swing towards the street. There 
should be two doors at least, — one for each staircase. 

The competition for prizes for model school- house plans, which took 
place in 1S80 in New York, has already been mentioned. The condi- 
tions upon which the committee of award based their judgment deserve 
to be quoted. In their opinion " a public school building to be erected 
in a large and densely populated city, should possess the following quali- 
fications, viz., — 

" I. At least tw T o adjoining sides of the building should be freely exposed 
to light and air, for which purpose they should not be less than sixty feet 
distant from any opposite building. 

"II. Not more than three of the floors should be occupied for class- 
rooms. 

"'III. In each class-room not less than fifteen square feet of floor area 
should be allotted to each pupil. 

"IV. In each class-room the window space should not be less than 
one fourth of the floor space, and the distance of the desk most remote 
from the window should not be more than one and one half limes the 
height of the top of the window from the floor. 



SCHOOL HYGIENE. II 

"V. The height of a class-room should never exceed fourteen feet. 

" V T The provisions for ventilation should be such as to provide for 
each person in a class-room not less than thirty cubic feet of fresh air per 
minute, which amount must be introduced and thoroughly distributed 
without creating unpleasant draughts, or causing any two parts of the 
room to differ in temperature more than 2° F., or the maximum tempera- 
ture to exceed 7°° F. This means that for a class-room to contain fifty- 
six pupils, twenty-eight cubic feet of air per second should be continu- 
ously furnished, distributed, and removed during school hours. 

" The velocity of the incoming air should not exceed two feet per sec- 
ond at any point where it is liable to strike on the person. 

"VII. The heating of the fresh air should be effected either by hot 
water or by low pressure steam. 

"VIII. The fresh air should be introduced near the windows; the 
foul air should be removed by flues in the opposite wall. 

"IX. Water-closet accommodations for the pupils should be provided 
on each floor. 

" X. The building should not occupy more than half the lot." 

The only comments by way of exception that need to be made upon 
this are, that in VI it seems hardly possible to expect a temperature vary- 
ing only two degrees all over a room, if the difference between ceiling 
and floor is intended to be included ; and further, that the method of intro- 
ducing fresh warm air, etc., given in VIII, is not the only desirable one, 
is will be shown under "Ventilation" later in this essay. In No. IV 
the size demanded for windows is based on the requirements of city 
architecture. 

In other respects the recommendations deserve unqualified approval, 
as embodying the chief sanitary requirements in a city school-house. 

Height of School Buildings. Not merely on account of danger from 
fire, but for reasons affecting the health of pupils, excessive height has 
been, within a few years past, much spoken against. It seems desirable, 
on the whole, to limit the height to three stories, of which the first two 
should contain most of the school-rooms. The reasons for this restric- 
tion are such as apply chiefly to girls of the age of fourteen and upwards ; 
more especially, to young ladies in normal schools and seminaries. Not 
to enlarge upon this point here, it is w r ell to notice the unwillingness of 
such girls, if placed in the upper story, to descend to the play-room or 
yard for recess. The climbing of many flights is an evil which may 
come about in another way, viz., when scholars study in one story and 
descend to another for each recitation. In such cases the need of con- 
sulting teachers before building is evident. The plan of the house should 
be made to depend on the plan of study, and architects can seldom fail 
to gather some useful information from those conversant with the uses to 
which their work is to be put. 

A point to note in conclusion is the smailness of the yards allotted for 
the children's play in American cities as compared with what is found in 
Europe. 



12 SCHOOL HYGIENE. 



III. VENTILATION AND HEATING. 



This is one of the chief topics, and one of the most difficult, connected 
with School Hygiene. 

It is comparatively easy to build a convenient and spacious house : the 
requirements are well known, the cost is tolerably definite, for a given 
place and time. The problem of merely heating a given space is also 
one of moderate difficulty. But ventilation is a matter about which a 
general opinion is hardly yet formed, and the cost of which is very vaguely 
known. People in general are not yet agreed as to what constitutes good 
ventilation — how much fresh air per hour is required. 

Between a barely tolerable system, eked out by opening windows, and 
a system which really furnishes a supply of from thirty to sixty cubic feet 
of fresh warm air per head and minute, there are many shades of differ- 
ence. Few have a mastery of the somewhat complicated questions in- 
volved ; very few have seen successful and logical experiments made ; 
and many are called on to act as judges — to act upon an opinion which 
they cannot have formed. 

Amount of Fresh Air and Cubic Space Required. It is unfortunate 
that authorities differ so widely on these points. The New York Metro- 
politan School Board sets the minimum allowance of space per head at 
from 70 to 100 cubic feet, according to age. Fortunately, this does not 
represent the general practice in that city, — though, to the eye, the appear- 
ance of many infant classes suggests the idea of sardines in a box. Most 
authorities would wish to double these figures, at least. 

According to recent inquiries in Boston, there is no corresponding law 
or regulation ; but it is customary to build rooms for fifty-six pupils, with 
an allowance usually ranging from 160 to 220 cubic feet per head. Prof. 
Kedzie, of Michigan, claims 300 cubic feet; A. C. Martin, 220 ; various 
German states, from 120 to 284. The Conseil Superieur d' Hygiene Pub- 
lique, in a recent report to the Belgian Ministry of the Interior, recom- 
mends a minimum of 6| cubic metres per head, or about 240 cubic feet, 
a space which requires the unusual height of 4 \ metres, or about 14 ft. 10 
in. The high position of the sanitary service, especially as regards 
schools, in Belgium, lends weight to their recommendation. 

It is the writer's belief that it is desirable to limit the size of classes to 
forty (40) pupils. Experts in education recognize the gain that accrues 
to the individual scholar from such limitation. If we base the calcula- 
tion on this figure, we have more liberty of choice between large and 
small rooms in making our plan for a building. The advantage of space 
is twofold ; — it enables us to introduce large volumes of air, fresh and 
warm, without danger of draughts ; and it gives more value to the prac- 
tice of airing-out the room by windows at recess times, since a large 
roomful of fresh air lasts longer than a small one. But there is such a 
thing as too much space, entailing difficulties in regard to discipline and 
teaching, and making it hard to secure good light. For example, a class 
of fifty-six, with an allowance of 250 cubic feet each, requires a room of 



SCHOOL HYGIENE. \ 3 

the capacity of 14,000 cubic feet, or 27 feet wide, 37 long, and 14 high, 
dimensions which can hardly be profitably exceeded, if indeed they are 
not too great already. 

As regards the amount of fresh air to be introduced hourly, it is desir- 
able to found our ideal upon the basis of Parkes & DeChaumont's views, 
which represent the best authority. By depending upon the testimony 
of their senses as to whether rooms were "close" or "fresh," these 
authorities reached the conclusion that it is not desirable to allow the 
amount of carbonic acid in air to exceed the proportion of 6 parts in 
10,000. Any higher proportion seemed to be attended with perceptible 
closeness. 

Now, assume that fresh air from out of doors contains 3$ p a *'ts in 
10,000, which is a trifle below the usual rate. A room of the capacity 
of 10,000 cubic feet, freshly filled with this air, and tenanted by one man, 
would receive from his lungs an addition of 2% cubic feet of carbonic acid 
in 4^ hours, raising the total to 6 cubic feet. If, then, 10,000 cubic feet 
will last 4^ hours, the supply for one hour should be 2,400 cubic feet, or 
for one minute, 40 cubic feet. 

The usual assumption is, that " fresh " air contains 4 parts, not 3I-, in 
10,000. If so, the hourly requirement is about 3,000 cubic feet, or 50 
per minute. Billings increases this to 60. If an average school-room of 
the better class contains an allowance per scholar of 200 cubic feet of 
space, there would be a necessity for renewing the air completely every 
four minutes, or fifteen times in an hour. This requirement, however, 
is intended to apply to rooms used day and night, such as barracks. For 
school-rooms, the amount may be less, owing to the opportunities for 
frequent airing, and the total disuse out of school hours. The writer 
agrees with Dr. Billings in the belief that, for schools, the allowance of 
from 25 to jo cubic feet j)er minute and head will answer all needful 
purposes, if supplemented by occasional airing-out during and after 
school. 

It is evident that if air is to be introduced so rapidly, there should be 
a liberal allowance of room, in order that the incoming air may not be 
felt as a draught. The outgoing air, by the way, is rarely felt ; but a 
very vigorous draught may be appreciable two feet from the register. 

Do childre7t require a smaller allowa?ice than adults? or, Do small 
children require less than large o?ies? 

One answer, in the affirmative, is derived from the estimates of the 
amount of C0 2 exhaled at different ages. Breiting gives it, for girls aged 
seven or eight years, at a little over 10 litres per hour ; at the age of eight 
or nine, 12 litres. If engaged in singing, it is 16.7 for the latter age. 
Boys aged twelve or thirteen expire 13 litres ; during singing the amount 
rises to 1 7. Scharling gives, for the age of ten years, close upon 10 litres \ 
for a boy of sixteen, 17.4 ; for a young woman of seventeen, 12.9 ; for 
adults, a little more. Pettenkofer & Voit give 16.8 for a weak man, and 
22.6 for a strong man. 

It would appear, then, that there is a decided difference to be allowed 



14 SCHOOL HYGIENE. 

for. Primary pupils expire less C0 2 than high school pupils, in the ratio 
of 2 to 3 ; or perhaps the difference is still greater. If a room ought to 
contain the cubic space of 250 feet per head for larger scholars, it need 
contain only 1S0 for the same number of small scholars. In other words, 
forty large and sixty small scholars can be accommodated in an equal 
space. 

This estimate, however, is admissible only on the supposition that the 
ventilation is efficient. In case of defect, or apprehended defect (and this 
covers a wide ground), the young children should have equal room with 
the older ones, on the ground of their comparative inability to cope with 
the deleterious effects of bad air ; also, because in contracted quarters the 
danger of draughts from windows is greater. It has been said that chil- 
dren need a proportionately large allowance, "because metamorphosis 
of tissue goes on more rapidly in them." We have two means of esti- 
mating the amount of tissue-change, — the quantity of C0 2 exhaled, and 
the quantity of food consumed. On the whole, the latter item is suffi- 
cient for the argument, and may be believed to represent the amount of 
change of tissue very well. It is quite evident that, though boys of fif- 
teen may consume as much food as men, children of eight do not. A 
supply of air, then, which would be liberal for a large boy, would be 
more than liberal for a small child. The degree of allowance to be made 
is a point upon which distinguished authorities differ. DeChaumont 
would place three times as many children of four or five years in a given 
room as youths of fifteen or sixteen, while Billings would allow very 
nearly the same amount for children of all ages. 

Dimensions of Ventilating Apparatus. Let us suppose the case of 
a school-house to be planned for thorough ventilation. It is assumed that 
all the air to be extracted is to be cari'ied by flues through the roof. We 
will first consider the flues for extraction. The resistance offered by 
friction is of great importance, and should lead us to make the flues of 
liberal size, as sfraight as possible, and smooth internally. A flue of less 
than eight inches internal diameter is not worth much. The inside 
should be finished in smooth plaster, or, better, with sheet metal ; never 
with rough brick unless very large. Angles check momentum very 
greatly ; so do horizontal passages. 

Suppose a single room to be ventilated by a single brick flue, straight 
and well made ; and suppose the only force to produce a current is the 
warmth of the air leaving the room at 68°. It is probable that if the flue 
is of moderate height, with no fire, the upward draught will seldom ex- 
ceed the rate of two feet per second. An average of two would be a 
liberal allowance. If there are fifty-six pupils, the chimney is expected 
to discharge 28 cubic feet per second, and in order to do this, it must be 
at least 14 feet in sectional area, or about 4 by 3^ feet inside measure. 
The register opening to this flue should be at least as large. (The reader 
may try to form an idea of this by measuring the dimensions on the 
wall.) 

Not to speak of the register, such large flues cannot be introduced into 



SCHOOL HYGIENE. 



15 




Fie: 6. 



a building already finished, and can hardly be thought of in a new plan. 
There is, indeed, no necessity of so large a shaft if we provide a some- 
what different arrangement. 
If convenient, we can cause 
the furnace-smoke to be car- 
ried up this flue in a cast-iron 
pipe, thus increasing the heat, 
and possibly doubling the ve- 
locity. In large buildings, 
moreover, the whole system 
must be centralized, and this 
is done in two ways. — first, 
by conducting the foul air 
from each room by long tubes 
to a central heated chimney ; and second, by grouping rooms so that they 
discharge their foul air at once into the chimney, without intervening 

"•ducts." The latter is the 
plan of the Bridgeport, Conn., 
high school, to be described 
presently. 

Three illustrations (Figs. 
6, 7, and 8) show how the 
7. first plan may be carried out. 
It is to be observed that they 
all imply the expenditure of 
extra heat to force a draught ; 
also that in No. 6 the heat is 
applied in a chamber in the attic (which may be of wood lined -with sheet 
metal) , while in the others it is imparted by the smoke-flue of the furnace. 
The most economical plan 
of the three is stated by 
Planat to be the last ; the 
least economical, the first. 
The Bridgeport school 
plan is illustrated 
next plan (Fig. 9) 
ventilated by two 
brick shafts, which curve 
and meet in one at the 
attic story. In their up- 
ward course they pass di- 
rectly by each school-room, and take foul air by one large opening from 
each. These same shafts also cany the tin flues for the hot air supply 
of the rooms, one such flue for each room. The heat lost from the tins 
goes to keep up the heat of the shaft, and increase the " suction" power. 
The smoke-flue is utilized in the same way, and there is a "suction coil" 
for extra heat in the upper part of the flue. 




fl 



in the 

It is 
large, 



Fie. 8. 



i6 



SCHOOL HYGIENE. 



With but one inlet and one outlet, there was need for special care in 
planning the position of the registers. The plan adopted seems to be 
quite successful in distributing the air and equalizing the temperature. 
The inlet for hot fresh air is near the ceiling : the current travels towards 
the windows : a descending current near the windows, originating in the 
cooling efiect of the glass, continues the movement, and finally there is 
a strong outward movement of air at the inner corner of the room on the 
level of the floor. Something like a circular movement is thus produced 
In the diagram (Fig. 10) arrows are introduced at points where currents 
are felt, and the intervening points may be filled in by the reader's judg- 
ment. The figure represents the room in section, with temperature takei 



Fig. Q. 



MOUTH OF FURNACE FLUE 
EXITS FOR AIR 



U'ALVES IN SHAFT 



SUCTION COIL 




COLD AIR 



COLD AIR 



BRIDGEPORT, CONN., HIGH SCHOOL. 
Vertical Section. 

simultaneously after the apparatus had been in operation forty-five min- 
utes. Similar arrangements have been since made, to the knowledge of 
the writer, in schools in Auburn, New Yoi'k, and Newton, Mass., with 
good success. 

The orifice for the exit of foul air ought to be a good deal larger than 
that for the inlet of fresh air. In examining Fig. 9, the reader is desired 
to make the correction mentally. 



SCHOOL HYGIENE. I? 

The use of steam power as a ventilating agent is not a novelty in other 
public buildings, but in school-houses it has been tried, so far as known 
to the writer, only in Boston, and that within a few weeks past. The 
experiment is one which it is very desirable to make, by way of testing 
its economical value. The arrangement consists of a fan placed in the 
space below the ridge-pole, within a box, propelling the air upwards 
through the cupola, and exhausting by good-sized flues from below. The 
motor is a high-pressure engine in the cellar, which seems to require 

Fig. io. 



12 ft. 



81° 



85° 



S ft. 120° 



>IA 



{ 



\ 



■vyQ 



75° 78° 



PL A TFORM 
73 o 



69° 



BRIDGEPORT HIGH SCHOOL. 

Vertical Section of a Room, shozuing Temperatures at a height of 

I inch, $\ feet, 8 feet, 1 2 feet from floor. 



from twelve to fifteen tons of coal during the winter, and the constant 
presence of an engineer. A new form of engine ("•vacuum engine") is 
proposed, requiring no separate fire, and run by jets of steam from the 
boiler which heats the school, at an extremely low pressure. No tests 
for carbonic acid have been made, but the anemometer test, applied in 
two schools, gave a rate of discharge equivalent to twenty-four cubic feet 
per head and minute, which is about as much as we can ask for. The 
expense of introducing the appliances is stated as moderate ; flues, not to* 
be considered, being required in any case ; vacuum engine (no boiler 
required), about $500 ; and fan, something more, besides cost of gearing 
to transfer power from cellar to attic. In one school a certain amount of 
rumbling noise is heard (but not complained of), due to vibrating motion 
in the attic, the apparatus having been introduced not as part of the 
original plan, but after the school was built. In the other building 
scarcely any sound was heard. 

The arrangement of flues for such a plan has nothing peculiar. It 
requires chieflv the avoidance of angles, or rough and narrow flues, and 
is represented in figure 6, the fan being placed at ****, just below where 
the cupola is set upon the roof. 

No system for exhausting air by hot flues or by steam power should be 
introduced without providing for the introduction of a corresponding 
amount of fresh-warmed air. Hence it follows that ventilation and heat- 



18 SCHOOL HYGIENE. 

ing constitute parts of one general problem, and that the same mind 
should plan both. 

" Indirect" heating is the only kind worthy of our consideration. In 
cases whei - e stoves are set in school-rooms, they should be made indirect 
heaters by the use of screens, as is hereafter described. For larger build- 
ings, steam heat, by means of coils arranged in boxes in the basement, is 
probably the best. Auxiliary coils may be placed in entries, but not, as 
a rule, in school-rooms. Ventilation cannot be had without some in- 
crease in the bills for fuel. There is reason, however, to think that the 
amount of increase is not so great as might appear. In our worst venti- 
lated schools there is a good deal of warmed air let out at windows, in 
an unsystematic way. 

Good ventilation implies that cold draughts from open windows are 
done away with : hence a lower degree of heat in the room is sufficient 
for comfort. It also implies a rapid change of air, with equalization of 
temperature, so that the feet are kept warm : this also enables us to be 
comfortable at a low temperature. A third point, bearing in the same 
direction, is the greater activity of the circulation and of the change of 
bodily tissue, and the consequent increase of bodily warmth in fresh air. 

The writer has at least twice found opinions strongly expressed in favor 
of the results of ventilation. Once in a new primary school at Springfield, 
Mass., where the teachers agreed that they could get along with the ther- 
mometer some degrees lower in their new, well ventilated quarters, than 
formerly was the case in close rooms. The other instance points indi- 
rectly in the same way. In the new building of the Massachusetts Insti- 
tute of Technology, with nearly perfect ventilation, the quality of the 
work performed is said to be decidedly superior to that which was done 
in the old building, which has no system worth naming. The ventilation 
in the new Institute building is very successful. It is effected by a fan in 
the basement, which forces air through openings in the inner walls of the 
rooms at a high point, the air escaping by flues in outer walls at low 
levels. The allowance per hour and head is 1,500 cubic feet in lecture- 
rooms, and from 2,000 to 4,500 in laboratories of various kinds. The 
analyses of air gave from 4.87 to 5.23 parts C0 2 in 10,000, in a room 
which was half full of students. The estimate for a full room would be 
from 7 to 8 parts per 1 ,000. Corresponding analyses in the old building 
gave from 9 to 12.34 m a room with doors and windows open, half full ; 
if filled it would probably stand at 21 or 22 in 10,000. Prof. Wood- 
bridge's estimate of the fuel burned last winter is 307 tons for the old and 
404 for the new building, and some allowance is to be made for the fact 
that all the boilers are situated in the cellar of the older building. Both 
are of nearly the same size, and are equally used, and for the same pur- 
poses. 

However encouraging these results, it is seen that perfection is not yet 
reached. By way of comparison, a few selected data are given, showing 
the number of parts in 10,000 of C0 2 in the air of various localities. (See 
tabled 



SCHOOL HYGIENE. 



19 



It is probable that the bad air of German schools is one cause of the 
prevalence of near sight and other defects of vision. 

The standard of 6 per 10,000 is not likely to be reached in schools at 
present. Perhaps we shall have to admit the practical justice of Prof. 
W. R. Nichols's remark, that 10 in 10,000 is as low as we can expect to 
find in schools with fair ventilation. 

AMERICAN SCHOOLS. 



Philadelphia. . . 

Boston. ... 

Boston 

Boston 

Michigan 

New York city. 
Lynn, Mass . . . . 



.1875 
1870 

•1875 
18S0 



•1873 
1SS3 



No. of 

rooms 

examined. 



9 

40 

in 

39 
46 

17 
8 



Parts CO2 
in 10,000. 



12.2 

I4-S 
11.9 
15.6 
22.9 
20.8 
l 7-S 



Observer. 



E. Thompson. 
A. H. Pearson. 
Draper & Nichols. 
W. R. Nichols. 
R. C. Kedzie. 
H. Endemann. 
Prof Hills. 



GERMAN SCHOOLS. 



Annaberg, 5 schools 

Wilhelm's Gymnasium in March. 

" in July. . . 

Celle, Gymnasium, various rooms . 

Celle, Volks-schulen, most rooms. 

" one room.. . 



39-9 


O. Krause 


55-8 


Oertel. 


22.9 


« 


20.50 


Baring. 


90 


« 


20 


« 



Much has been said regarding the proper position for outlets and 
inlets for air. One false view may be corrected at once, — the notion that 
carbonic acid gas is the agent that is chiefly noxious, and that this gas 
seeks the lower levels. It is not specially dangerous in quantities found in 
schools — the animal vapors from skin and lungs are more so — but it repre- 
sents the degree of organic pollution fairly well. It is not found chiefly at 
a low level. If there is any difference, the upper levels are sometimes more 
impregnated, owing to the breath rising in a cool room ; but the differ- 
ence is small, and, in a room with rapid ventilation, not distinctly trace- 
able. The air from the pupils' lungs may be assumed to be distributed 
through the apartment rather quickly. The process of ventilation then 
becomes, not a removal of the exhaled air, but a dilution by the introduc- 
tion of large quantities of fresh air. 



20 SCHOOL HYGIENE. 

A test for carbonic acid is not easily made in a way to satisfy scientific 
demands, but an approximate test can be made in a minute by an un- 
skilled person. An ounce of fresh lime-water in a ten-ounce bottle of 
the air to be tested, shaken vigorously for half a minute, will indicate a 
fair degree of purity, if it is not distinctly made turbid. One should have 
a little practice, even at this simple operation. 

The writer has endeavored to make a convenient and portable appara- 
tus which will give an indication of the number of parts in 10,000, within 
a range of error not exceeding one part. To some extent the instrument 
is successful. It is based on Lange's method. A series of bottles of 
known size was chosen, graded from large to small, and fitted in a 
wooden frame. The whole apparatus is carried to the room to be tested. 
The bottles have been previously filled with water, and when inverted the 
air fills them at once. They are stoppered, and carried to the laboratory, 
where a given amount (say one half ounce) of lime-water (chosen as 
being less liable to change than baryta- water) is introduced into each, 
and also a few drops of a solution of phenolphthalein, which gives a rose 
color to the lime-water. By shaking for a good many minutes the car- 
bonic acid is made to neutralize the lime ; the approach of complete neu- 
tralization is marked by the fading of the rose color ; and when satisfied 
that the process has gone on long enough, we select the largest bottle that 
shows the complete change, and say, — 

The air in this bottle measures (say) 10 ounces ; it contains enough 
C0 2 to neutralize (say) - 1 - ounce of lime-water : how much C0 2 is here? 
and how manv parts in 10,000 parts of air does it stand for? 

The calculation is of course made previously for each bottle, so as to 
reduce the labor of a test to the mechanical operation. The act of shak- 
ing is fatiguing, and the charging of the bottles requires some practice, 
and a well graduated tube. No figures arc here given, but by a com- 
parison with simultaneous analyses made by Pettenkofer's method, an 
encouraging degree of accuracy has been observed. The point of diffi- 
culty in this and similar processes is to determine when the carbonic 
acid is to be considered as having been fully taken up by the lime. This 
fault seems to attach to Mr. Owen's ingenious process, given in Billings's 
"Ventilation and Heating." 

Source of Supply of Air. The purity of the source must be cai-efully 
guarded. A wooden duct is the usual means of conveying the air across 
the cellar to the furnace. Such ducts easily open at the joints, and let in 
cellar air : hence painting from time to time may be useful, unless tin be 
substituted, or galvanized iron. The interior should be accessible in some 
way for cleaning, as dust cannot but accumulate with time. The inlet, 
out of doors, is to be guarded with a wire screen, and is so situated as 
to be out of the way of mischievous persons. Bad smells are sometimes 
noticed in a school, which enter through this channel. It is hard to tell, 
in certain neighborhoods, just where to place the opening. The ground 
is damp ; the air at ten feet is odorous for various reasons ; and at thirty 
feet the smoke of neighboring chimneys is blown into the inlet ; — it is 



SCHOOL HYGIENE. 



21 



usual, however, to make the cautionary remark that malaria and damp- 
ness linger near the ground, and, as a rule, ten feet from the ground is a 
good place. 

Scrupulous cleanliness of the cellar is necessary. If there are water- 
closets there, they had better not be near the ducts, nor even in the same 
division of the cellar, since the ducts are provided with doors which are 
liable to be left open contrary to orders. The misuse of such valve-doors 
is one of the crying sins of janitors. Many a master has a perpetual Avar- 
fare with this functionary on account of this. The janitor's object, first 
and last, is the saving of coal in order that he may receive credit for 
economy, and his habit is to close the outer valve, opening the one that 
leads from the cellar, thus feeding his furnace or coils with cellar air at 
6o° instead of the cold air out of doors. In this way the writer has found 
a school-house filled with air which must have passed through the fur- 
nace two or three times, being drawn down through the entries to the 
cellar, and then sent back "through the furnace. Excessive heating of the 
air is not so frequent a fault at present as formerly. A report made to 
the Boston school board in 1846 complains that the air sent to school- 
rooms is frequently heated to 500° or 6oo°. This may be simple exag- 
geration, but there is no doubt that a heat approaching 200 is not un- 
common at present. Circumstances alter the 
requirements greatly, but for schools by day- 
light, the range should not much exceed 120 
F., nor fall much below 8o°. In order to 
fulfil this demand furnaces and boilers should 
be made very large. Steam heating is one 
of the best methods. The pressure upon a 
boiler of proper capacity need never exceed 
ten — perhaps it should not exceed five — 
pounds to the square inch, and it should 
frequently run down to one pound. The 
danger of explosion need hardly enter into 
the calculation if there is good management. 

Vent Hating- Stoves. A useful apparatus 
for aiding ventilation is furnished by a class 
of stoves which are provided with an inlet for fresh air, and a chamber 
for warming it before it is introduced to the room. 

Figure 11 shows a stove having a jacket of sheet metal, a space be- 
tween the jacket and stove, and a fresh-air 




t 



D 



(ZD 



Air enters by 
open window. 



w~-^ 



Fig. 12. 



flue, with a valve operated from the room. 
The principle, as regards air-supply, is not 
essentially different from that of the "Fire 
on the Hearth," the '• Jackson Ventilating 
Grate," and Galton's ventilating fire-places. 
The method is practically valuable, though 
the stoves I have seen do not really supply 
enough air ; that is, a stove larere enough. 



22 



SCHOOL HYGIENE. 



\ 



□ 



E*a 



F— TX 



to heat a given room does not introduce nearly enough air to ventilate 
it. The column of hot air is very short, and the velocity moderate. 
Yet, where stoves are to be used, there is an obvious gain in using this 
kind. It ought to be supplemented by a powerful chimney-draught, the 

chimney being made of liberal 
size, and heated by the passage 
Fi cr . 13. of the stove-pipe: an opening 

for ventilation is to be made 
near the floor. In still other 
ways ventilation may be aided 
by the stove-pipe, as will be 
seen from Figs. 13 and 14. 

Figure 12 shows a screen 
(supposed to form a semicir- 
cle) placed by a stove near a 
window, which is opened. 

Figure 13 is like Fig. 11 in 
principle. 

Figure 14 shows how a low- 

Ier story may be ventilated. 
The last four illustrations are 
from Billings's "Ventilation and Heating." 

The evaporation of water in connection with heaters is probably useful, 
but the writer is not inclined to consider the matter one of primary im- 
portance. It is successfully 
dispensed with in some of 
the best ventilated new wards 
in hospitals. 

Children often come in 
with cold and damp feet. 
It is desirable to provide 
some kind of foot-warmer 
in the hall or basement. A 
good one is made of an iron 
plate, z\ or 3 inches thick, 
set on a flat steam-coil. 

Ope?iing Windows. This 
may be regarded in two 
lights, according as the schol- 
ars are at work, or moving 
and exercising. To keep windows partly open seems an absolute neces- 
sity in many school-rooms. In one-roomed country schools, one of the 
first steps in sanitation is to insist on the upper sashes being arranged so 
as to be lowered. An open window is an evil, nevertheless, in cold 
weather. The palliative measure to be recommended is a strip of board 
a few inches wide placed so as to deflect the current fron~ under the 
lower sash, and make it pass above the heads of pupils. This is a decided 




SCHOOL HYGIENE. 33 

mitigation of the draught. It is very often liked in rooms where the 
ventilation is otherwise bad. A tilting sash at the top of a window can- 
not safely be used in winter. Such a sash, however, ought to be placed 
over every room door to enable the occupants to share to some extent in 
the purer air of the entries. There is no question of the good done by 
temporary opening of windows and doors for a minute or two while 
scholars are exercising. The effect may be supposed to disappear in two 
minutes or so ; but when combined with a short physical exercise in the 
standing posture, its effect, both moral and physical, is undeniably good. 
In a very carefully conducted school known to the writer, this is done 
every hour, the period of five minutes being allotted for that purpose, 
unless there is a regular recess. At recess time, also, it is the rule that 
no child shall remain in the rooms, but that all shall go to the play-rooms 
under charge of their teachers, the windows in the mean time being 
opened by scholars deputed for the task. These measures, well carried 
out, greatly relieve the condition of a school which has no efficient sys- 
tem of flue ventilation. 

The " Eureka" ventilator is an opening in the wall to let in air directly. 
It has a valve, and the passage is bent so as to throw the air upwards. 
It is a useful accessory in some cases where a thorough ventilation is not 
planned for. Similar openings are often found behind steam-coils in 
school-rooms. Their utility is delusive ; — they deliver a very small quan- 
tity of air, and are liable to be stopped up by accident, or for the pur- 
pose of keeping out the cold. 

Much has been said of the supposed capacity of cast-iron stoves to let 
carbonic oxide gas pass out through their pores, thus contaminating the 
air with a peculiarly deadly poison. The present weight of evidence 
does not sustain this belief. 

IV. SEWERAGE. 

It is difficult to trace any large amount of disease in schools directly to 
offensive privies or sewers. There can be, however, do doubt that some 
is so caused. The school is often supplied with water from a contam- 
inated well. Bad air and stenches are not always provocative of illness, 
but the common-sense of civilized races suspects them, and there is no 
doubt that they may promote debility, headache, loss of appetite and 
digestive tone, and general depression of vitality ; while in the minds of 
some physicians there is no doubt that dysentery maybe caused, and per- 
haps typhoid fever, and that scarlatina and diphtheria may be aggravated 
by exposure to foul air. Pneumonia, tonsillitis, rheumatism, and neural- 
gia are probably to be included. 

Although drainage, as applied to school buildings, is governed by the 
general rules applicable elsewhere, it may yet be desirable to note, in 
passing, the chief of these rules. A certain number of points of more 
special application will be noticed afterwards. 

In all houses, whether used for school purposes or not, the drain, soil, 
and waste pipes ought to be of iron, visible and accessible throughout 



24 SCHOOL HYGIENE. 

their course, if possible ; without angles, as straight as possible, and 
never horizontal. Soil and waste pipes are to be carried up full size, 
two feet above the house roof, and there guarded against the weather. 
A trap is to be provided for each sink, basin, urinal, or closet, and a 
running trap for the outlet of the drain, with an opening from the drain 
for ventilation, just inside the trap. Safes are to be connected with the 
drain directly. Rain-water leaders are not to be used for any other pur- 
pose, and vice versa. The best trap for sinks is, perhaps, the ball trap. 
Ordinary S traps are often shallow, and ai - e rather more easily siphoned 
than D traps. Traps are to be ventilated by i^-inch pipe leading to the 
general ventilator (z. <?., the continuation of the soil or waste pipe) 
above all other inlets. If not ventilated, the omission must be made upon 
good authority. Bell traps are convenient for the floors of urinals, but 
they are rather inefficient unless the seal is made deeper than usual. 

In many towns there is a supply of aqueduct water, but no public 
sewer. In this case the drain usually discharges into a cesspool, loosely 
built, which permits the escape of fluids into the soil. This arrangement 
is satisfactory when there is a good deal of spare land, and when the soil 
is light and gravelly. In a clayey soil it may be entirely inadmissible. 
If the population is even moderately compact, sewers should be provided 
at once, under peril of infecting the subsoil air to such an extent as to 
influence the air of cellars. City schools are usually provided with 
water-closets proper, or with flush-tanks or iron latrines. In country 
schools the ordinary privy is almost universal. Good water-closets are 
doubtless the best arrangement, so long as the}' are kept in order. No 
kind yet invented is free from the danger of derangement. A hopper 
which gives a full and quick dischai-ge of water is probably the best for 
schools. The discharge may be dependent on the movement of the door 
or seat, or may be arranged to occur at once in all the bowls at a given 
signal. 

The flush-tank is a long vault of masonry, over which the seats are 
built. It should have a round bottom and rounded corners. At one end 
is a tap of water ; at the other, in the bottom, a plug to let out the con- 
tents. The janitor should remove the plug, and flush and swab the inte- 
rior at least once a day. With proper ventilation there need be no of- 
fensive odors. If placed in a well lighted cellar, it will give satisfaction as 
long as it is carefully attended to ; but such is human nature, that we may 
expect to find a certain proportion of cases in which due care is not given, 
and consequently dissatisfaction is felt. There is a great difference of 
opinion among intelligent heads of schools upon this point, some being 
unwilling to tolerate these arrangements under the house-roof, while 
others are strong in support of them. On the whole, it seems better, if 
we cannot be sure of the future character of the service rendered, to place 
all of them out of doors. A flush-tank will not freeze in the climate of 
~NewYork city if emptied at night. In colder places it maybe necessarv 
±o' empty not only the tank (which in any case should be always done), 
but also the pipes leading to it, directly after school. 



SCHOOL HYGIENE. 25 

An unobjectionable apparatus consists of an iron sink coated inside 
with a firm glaze, rising to contact with the seats, and only deep enough 
to hold a few inches of water, with a suitable space above. There should 
be no riser. The whole should be above ground, in a place moderately 
warmed; the water to be drawn off daily, and in cold weather not re- 
placed till the next day. For an out-of-doors sink, if iron is used it must 
not be supplemented bv a wall of masonry built above it, as the contrac- 
tion and expansion of the metal cause a breaking away from the masonry. 
As regards freezing, the writer is informed by the superintendent of 
schools at Springfield, Mass., that it does not occur when the water is 
shut off from the out-door sinks and drawn off. 

A school-house should have one water-closet in-doors, for the use of 
females. A building of two or more stories may properly have one on 
each story, in order to save girls the fatigue of climbing stairs in cases 
where the privilege is desired, and also for the teachers' use. 

The urinal appears to present a difficult problem ; but the whole mat- 
ter lies in two words — non-absorbent surfaces -and frequent cleaning. 
One of the best forms is composed entirely of slabs of slate, forming a 
wall five feet high, with a gutter at its foot. The gutter is cut in the 
floor-pieces on which the pupils stand. Upright slabs divide the space, 
in the interest of decency. Slate is almost impervicas to moisture, and 
is made quite so by oiling with linseed oil. The apparatus in question 
is usually furnished with a perforated water-pipe, to keep the front sur- 
face of the stone moistened with a sheet of water. The idea is a good 
one, but requires such exactness of mechanical work that the jets are 
rarely in perfect order. It has the further disadvantage of seeming to 
excuse a part of the duty of scrubbing. No portion — side, base, or back — 
should be neglected in this respect. All these surfaces are liable to grow 
foul. The amount of work needed to give thorough cleaning is consid- 
erable, but it is the only way to secure purity. The janitor's task ought 
to be lightened by having the whole floor of the apartment slope towards 
the gutter, so that the hose can be used freely. Some urinals have a 
raised platform, in order to define the place to stand on. The better way 
would be to have a depression, which would equally define the position. 
A monitor, in either case, should stand by to check irregular behavior. 

All complication of structure in these departments should be avoided. 
Concealment of the basin of a water-closet by wood- work is not desira- 
ble, and the wooden seat should be so fitted that it can easily be removed 
for cleaning or renewal. The urinal needs no trough. It should be 
made of materials which are not porous : no metal work is admissible, 
for rust is sure to come, and the animal matter of the urine so saturates 
the rust that it can hardly be soaked out. Paint soon scales off from 
metal. Wood can be protected by paint for a time, and then be- 
comes soaked with urine unless repainted. The writer has seen marble 
used — a material whose absorbent powers may be seen in the lnr^e slabs 
used in restaurants, depots, and such places. 

Little need be said about the common privy attached to most country 



26 SCHOOL HYGIENE. 

schools. In many cases this is the last thing attended to. It is practi- 
cally outside of the teacher's supervision, and one can hardly blame a 
young and modest woman for failing to see that her duty lies in this direc- 
tion. It is generally a first-class nuisance as regards odor, insupportable 
if placed within a convenient distance ; but if set off fifty feet or so, the 
exposure which the pupils undergo in cold or wet weather is a serious 
matter. In perhaps one half of the cases it is out of repair. The accu- 
mulations go on for a year at a time. Finally the walls are covered with 
dirty scrawls ; and very commonly the girls' closet is contiguous to the 
boys', so that every thing is heard through the partition. 

The remedy for a part of these troubles may be found in a more active 
interest on the part of the school trustee. He can have the place repaired, 
the scribbling effaced with a plane, and paint applied so as to give a 
thoroughly neat look. He should try to have both the teacher and the 
scholars cooperate in maintaining a high standard of neatness, securing, 
if possible, an occasional visit from the teacher, and making such him- 
self, so as to insure that no breakage or injury goes unnoticed. 

Most privies are too dark. Two closets in immediate contact do not 
insure a proper and modest degree of separation between the sexes : in 
such a case, the boys and girls should have recess at different times. If 
there are really two separate out-houses, it is well to have them, and the 
approaches to them, separated by a sufficient fence. There ought to be 
plank walks, or raised ways (paved, asphalted, gravelled) , to enable the 
scholars to go dr} r -shod. But the plan which commends itself to the writer 
as by all means the best for country schools is the use of dry earth in 
vaults, emptied weekly, in a shed close to the school-house, and access- 
ible by a short, covered way. It may be thought best to retain the old 
style of privy for the boys, keeping it at a distance from the house as 
before ; but for girls and little children it is most certainly desirable to 
have a place which they can reach without danger to health. 

Not to mince matters, the direct exposure of a sensitive part of the 
body to the gusts of a north-east storm is not a thing to be regarded as a 
trifle ; in certain states of the system it may be highly dangerous. And 
both girls and small children are sometimes led to slight the calls of 
nature, to their bodily harm, by fear of exposure to bad weather. The 
plan here suggested is one which may be found illustrated in the report 
of the Connecticut State Board of Health for 1883. l In that report there 
is given a plan for a country district school, which places both privies 
under the school roof, but at opposite ends of the structure. Difficulty 
in keeping the boys' place in order (owing to the need of a urinal) is 
anticipated, and there is presented, as an alternative, a plan which con- 
tains only the girls' closet, as is here recommended. 

The figure appended is taken from that report (numbered figure 10 — 
in the present essay, No. 15). It shows a single school-room with sep- 
arate entrances for the sexes. On the girls' side at the rear is a small, 
square building, isolated from the main building by an 18-inch oassage- 

1 In a paper by the writer of this essay. — Secretary. 



SCHOOL HYGIENE. 



27 



way around it, but intended to be sheltered by the same roof. The detail 
of the construction of such a closet is very simple. It requires a recep- 
tacle, consisting of a brick trough about two feet wide, rounded at bot- 
tom and corners, and coated internally with coal tar to prevent the ab- 
sorption of fluids or gases. The coating is continued over the top of the 
bricks and down the front as far as exposed. The bottom is an inverted 
arch of masonry, bedded in cement and coated with the same, and pro- 
jecting slightly at the outer end to facilitate removal to buckets. Four 
feet is a sufficient depth. The bottom ought not to be so low that water 
from the surrounding land can run into it ; and it is better that it should 



Fig. if. 



Fuel 



Porch 



Porch 



be raised above the ground level for convenience in removing the con- 
tents. There should be a bin for dry earth in a sheltered place handy 
for use. Two inches of this earth, finely powdered, are to be spread on 
the floor of the pit at first, and a little sprinkled on daily : a complete 
removal is made at the end of each week. 

The present writer would corroborate the plan here proposed by cases 
which he has recently seen, in which the earth removal system is carried 
out with entire success. An ordinary projection in the rear answers, 
every purpose ; the chamber ought, however, to be isolated by a narrow 
passage-way, furnished with screened windows, which should be kept 
open. The portable earth-closet may be found useful, but in reality it 
possesses no advantage over this arrangement. 

The only disinfectants required for well arranged water-closets are 
water, soap, and fresh air. For earth-closets, no more than these and 
earth are needed. Privies ought not to become offensive : treatment with 
earth should be resorted to, and if that is thought inapplicable to deep 
vaults, then let the vaults be shallow for the purpose of speedy removal. 
But in cases of existing nuisance, or in epidemics of fever, dysentery, or 
cholera, it is well to be provided with a temporary remedy ; and for this 
purpose, chloride of lime, or corrosive sublimate, as recommended by a 
committee of the American Public Health Association, may be used. 
Chloride of lime has the disadvantage of a strong smell. Whichever is 
used may be prepared by dissolving in soft water chloride of lime (of 
the best quality) in the proportion of a pound to four gallons, or cor- 
rosive sublimate, a pound to twelve gallons. The latter solution is to be 
colored with permanganate of potash (nine drachms) to prevent mis- 



28 SCHOOL HYGIENE. 

takes. Of the former solution, use a quantity equal to the supposed solid 
contents of a vault ; of the latter, one fourth as much. 

If used undissolved, one pound of chloride of lime corresponds to thirty 
pounds of the solids; one pound of corrosive sublimate to five hundred 
pounds. Subsequently, chloride of lime may be freely sprinkled over 
the contents daily. A corrosive sublimate solution may be used for the 
same purpose, four gallons a day, made by the following formula : Cor- 
rosive sublimate and permanganate of potash, of each 2 drachms 
(\ ounce), dissolved in a gallon of soft water. This may be kept in a 
tub or crock, not in a metal vessel. As a precaution in case of an epi- 
demic, wash the interior of the vault daily with this. If green vitriol 
{sulphate of iron) is used, take a pound and a half to a gallon of water. 

V. HYGIENE OF THE EYE. 

During the period of school-life, as is now generally known, certain 
affections of sight increase. It would appear from the uniformity of the 
results of investigations that the increase is a general rule ; and most of 
those who have treated of the subject have considered it due, in a great 
degree, to the effect of over-exertion of the eyes in school, more partic- 
ularly when the light is bad and the rooms unwholesome. It is generally 
accepted as proved that near-sight is very liable to be inherited. Far- 
sight (old-sight) is also found in children, and, like near-sight, it increases 
in frequency and degree as children grow older, until somewhere about 
the age of fifteen it begins to be less frequent, and at the age of twenty, 
among students, near-sight decidedly preponderates over far-sight. Dr. 
E. G. Loring has given diagrams illustrating this fact in the case of three 
nationalities, — the German, the Russian, and the American. The ob- 
servers, whose facts are taken for the diagrams, are Conrad, who exam- 
ined 3,036 eyes of school-children in Konigsberg ; Erismann, who exam- 
ined 4,35s eyes of scholars in St. Petersburg ; and Derby & Loring, Who 
examined 2,265 eyes in New York schools. The ages in all cases run 
from the youngest to the oldest pupils, including members of superior 
schools, up to the age of twenty. In the German table the percentage of 
near-sighted eyes rises from HxV m the young children to 62^ in the 
oldest ; in the Russian, from i3tV to 43 T ^- per cent. ; and in the Amer- 
ican, from 37]- per cent, at six to seven years to 26-/^ per cent, in the 
twenty to twenty-first year. 

There are a good many other similar series of observations, all agree- 
ing substantially with these, but the German percentages are always very 
much higher than the American. This is not surpi'ising if school work 
has anything to do with the result, for German children in all superior 
schools (real-schulen and gymnasia) are made to do an amount of work 
which is incredible to our school-boys, and with some results to show in 
the way of intelligence, too. German children in America also show a 
decidedly greater percentage of near-sight than American children, 
owing, no doubt, to hereditary influence. In a board-school in London, 



SCHOOL HYGIENE. 29 

Brudenell Carter has lately found nearly 10 per cent, of near-sight among 
267 children. These are the facts, and to most minds they seem to point 
to a tendency in national life which is truly alarming. It is a distinct 
drawback to a person's usefulness to have abnormal sight ; to have to 
wear glasses is a serious drawback for many purposes ; and yet Ger- 
many, which is leading the world in education, is far ahead in respect to 
near-sight, and we seem to be following her in both points. 

There are those, however (as Landolt), who lay the chief stress, as 
regards causation, upon general conditions of health, maintaining that 
hardship and poor fare constitute one of the chief causes of near-sight. 
It may be so, and this is not the place to enter into the argument satis- 
factorily ; but if so, how shall we apply the doctrine to the case of Am- 
herst college, where Derby's strictly accurate statistics show an increase 
from 44 T %- to 5o t 8 q- per cent, during the four years course ? In Amherst 
the conditions of living are as favorable as can be found. Not only is 
there no "hardship and poor fare," in Landolt's sense, but the young 
men are under a regime of plrysical exercise which produces a distinct 
effect in lessening illness during their residence. 

A brief statement of the leading causes, not in any presumed order of 
frequency, is given here : 

1 . Inherited tendency: 

2. Study while the system is in a weakened condition. 

3. Study in a bad light. 

4. Study in a bad posture. 

5. Study while the eye or brain is fatigued or congested. 

6. Study in excess at the formative period of life, when the bodily tis- 
sues easily assume a wrong bent. 

These will probably cover the ground, so far as relates to our present 
practical object, pretty nearly. The writer ventures also to offer a series 
of practical remarks in the form of rules at this point, leaving further 
discussion till later. 

RULES FOR USING THE EYES. 

In school work we should require, — 

1. A comfortable temperature, and especially let the feet be kept 
warm and dry. 

2. Good ventilation. 

3. Clothing at the neck loose. The same as regards the rest of the 
body. 

4. Posture erect ; — never read lying down or stooping. 

5. Little study before breakfast, or directly after a hearty meal ; none 
at all at twilight or late at night. 

6. Great caution about study after recovery from fevers. 

7. Light abundant, but not dazzling. 

8. Sun not shining on the desk, or on objects in front of the scholar. 

9. Light coming from the left hand, or left and rear ; under some cir- 
cumstances from in front. 



30 SCHOOL HYGIENE. 

10. The book held at right angles to the line of sight, or nearly so. 

1 1 . Frequent rest by looking up. 

12. Distance of book from the eye about fifteen inches. 

As regards the causes. No. 2 refers especially to the case of conva- 
lescents after measles, scarlet fever, and other weakening fevers. No. 6 
requires attention on account of some suggestive remarks made by Dr. 
Loring in the report referred to. He enlarges on the comparative neg- 
lect of out-door life, and the unwholesome habits of eating and living 
that are found among German children as contrasted with the free play 
and plenty of fresh air that boys have in our country. He also asserts a 
belief that since myopia is a disease of childhood, and rarely originates 
after the age of fifteen or sixteen, it is desirable to give children little 
severe study until after they have passed that age. More concretely, he 
points to the life of an English school-boy, with his long hours of foot- 
ball and cricket, as a better ideal than the German plan. 

As regards the rules,— 

Nos. 3 and 4 are intended to prevent the occurrence of congestion of 
the head, which is very likely to injure the eye. A recumbent posture is 
bad for another reason, viz., because it places the eyeball in unaccus- 
tomed positions, disturbing the equilibrium, and deranging the habitual 
action of the eye muscles. 

No. 5. Study before breakfast is usually work done at a disadvantage, 
since that period is one at which the strength of the system is at a low 
point in many people. If study is done by artificial light, the trouble is 
much woi"se. * 

No. 7. Some persons are unduly sensitive to light, while others re- 
quire an amount which is excessive for the average person. Regard may 
be had to this fact in arranging the pupils. Windows of ground glass, 
If within the range of sight, are annoying on account of a kind of daz- 
zling effect ; if the sun is upon them, they are intolerable. 

No. 9. If light comes from the right hand, the pupil's hand in writing 
shades his work annoyingly. If from the rear, he derives no direct ben- 
efit from it unless he turns himself so as to get rid of the shadow ; this 
is the position required in writing by some teachers. A front light, from 
a window so high that pupils practically are not awa . e of its presence, 
is good for the purposes of writing ; but such a light can hardly be 
obtained in a class-room without annoyance. Practically, there must be 
no windows for scholars to face while employing their eyesight upon 
tasks. This rule also forbids placing black-boards between windows, so 
that scholars are obliged to face a full light while trying to read what is 
written on them. And since the black-board is one of the chief instru- 
ments of instruction, and a large extent of it is held desirable, there is an 
advantage in restricting windows to one side of a room, so that the strip 
of black-board may run around three sides unbroken, and with every part 
of it in a good light. 

No. 10. The desk lid slopes for the purpose named. It is useful to 
have light frames for holding books in a more upright position while no 



SCHOOL HYGIENE. 3 1 

writing is going on. Some desks are made with a joint m the middle of 
the lid, giving the means of obtaining such an inclined book-holder. 

No. 11. The old rule, which punished all who looked tip, must be 
given up. If a pupil is restless and does not apply himself, his case can 
be reached in various ways, but not by a prohibition of this sort. 

No. 12. This distance need not be an invariable one at all times. If 
generally observed, it will correct the habit of stooping. In teaching 
penmanship, very great care is needed to prevent the formation of bad 
habits as regards attitudes. The author has seen a whole roomful of 
children writing, with their eyes at an average distance of less than three 
inches from the paper. This exercise must not be engaged in if cloudy 
weather makes the light poor. Ink should be of a kind that gives a per- 
fectly black mark when first put on paper, not the thin, bluish fluid 
which is black the next day. 

This is the proper place to mention with condemnation the atlases 
which are often used, crowded with detail in small, delicate letters ; also 
the small, " school " editions of large, standard dictionaries, printed in 
type which, though clear, is exceedingly fine. Many school-books of 
our day deserve much praise for their clear, bold type. The use of large- 
type charts in teaching an entire class is to be commended as avoiding 
the necessity for a certain amount of poring over books. 

Here we may repeat what has already been said aoout very deep or 
wide rooms. Many such are wholly unsuited for comfort in writing. 

If there is a tendency to near-sightedness, no pains should be spared to 
prevent a child from getting the habit of holding his eyes too near the 
book. The distance of fifteen inches is not great; but a child must sit 
up in order to maintain it. This connects the present topic with the 
question of school-desks, of which it will be convenient to speak else- 
where. The maintenance of a true posture is dependent on true propor- 
tions of desk and seat. When these are obtained, and a child with near- 
sighted eyes is unable to see clearly at the distance named, it is the opin- 
ion of many modern ophthalmologists that he should be furnished with 
glasses just sufficiently strong for the purpose of desk work. At the 
same time he may be prevented from crouching down by the use of an 
apparatus which keeps the head at the distance required. Such an ap- 
paratus can be made so as to give no annoyance, and can be kept per- 
manently screwed to the desk. Forster, in 1883, reported several cases 
of remarkable improvement under this treatment. 

Although this is not a place for discussion of the points involved, it 
maybe well to mention that the act of keeping the eyes close to an object 
is held to involve a muscular effort, both in the act of converging the eye- 
balls, and also in the (unconscious) act of accommodating the lens by 
the ciliary muscle, which contributes to the increase of existing near- 
sight, if it does not originate it. The best light for working purposes 
comes from above, and is nearly white. This suggests two points : 

I. Windows throw light very obliquely on distant objects. It is held 
by the best authorities that in general they afford sufficient light only 



32 SCHOOL HYGIENE. 

when the distance from the windows does not exceed once and a half 
times the height of the window itself. This restricts the depth of a room 
to about twenty feet ; a few more may be allowed for the width of an 
aisle. In one of the handsomest high school buildings in the country the 
depth from windows to opposite wall is forty feet, which cannot be recon- 
ciled with true principles. 

2. If light from above is to be sought, the upper part of the window is 
most valuable, and should be placed within six inches of the ceiling. 
This greatly improves the illumination of the ceiling, which is itself a 
very important light-giver. The lower part of the windows is not of so 
much consequence. It is desirable that they should not be so low as to 
let in light full upon the face horizontally. If the sill is placed four 
feet from the floor, no serious loss of light occurs. It is usually stated 
that if the surface of window-glass is calculated, it should amount to from 
\ to \ of the floor surface. Of course this depends somewhat on the 
locality. In order to secure the required amount, one side of the room 
must be made as full of windows as is consistent with the 'strength of the 
wall. The tint of the walls should be a neutral shade of blue, quite light. 
In general, paper is less cleanly than a hard finish. 

Blinds should keep out the sun, and admit light and air. They are 
often poorly made ; the rolling slats get out of order. They should be 
of a light color; natural -wood color changes to a dark brown in time, 
but a light green tint is very pleasant, and admits a sufficiency of light 
when the sun is shining on the blinds. Solid shutters are not suitable. 
Curtains ought to be provided. The kind which rolls from the bottom 
is best, for it cuts off the horizontal light, which is often very annoying 
to the teacher as well as the scholars, while it leaves the upper part of 
the window free. If it is thought best to place any windows in the rear 
end of the room, they should be provided with these shades. Or the 
■windows in that situation may be placed at the height of six or eight feet 
from the floor. 

Projecting "architectural features," as cornices and pillars, are not to 
be allowed to interfere with -windows, or lessen the amount of light enter- 
ing. Windows must be square at the top. 

VI. SCHOOL-DESKS AND GYMNASTICS 

Some additional points are here to be given : 

1. Support for the feet. This needs special attention in the case of 
little children. Wooden foot-rests ought to be given when needed. 

2. Curves adapted to the body. The seat ought to be " curved," i. e.,, 
hollowed. The back in American chairs is usually sloped so as to fur- 
nish an easy support in lounging. Some such chairs are so persuasive 
that one can hardly sit upright in them : this is a great fault, for the 
school ought to teach an upright carriage of the body. The chairs used 
in Germany, though the patterns vary greatly, are commonly m^de upon 
the principle of supporting only the lower half of the spine, usually by a 



SCHOOL HYGIENE. 33 

short, nearly upright, board. Many of our own chairs might be greatly 
improved by an approach to this pattern, the principle to be followed 
being this, that the back of the chair should fit the pei'son closely at the 
lower part, where the spinal column needs support. I have seen a young 
lady in a high school suffering a good deal from pain due to the want of 
support at that point, which was relieved by placing a cushion there, 
behind the pelvis. No seat that can be devised is suitable for long con- 
tinued occupancy by healthy children. Their bodily growth is impaired, 
and deformity is caused by the mere want of bodily activity. A cure 
for the crooked spine is not, therefore, to be had by carefully adjusting 
the size of the desk to that of the seat, and by giving the appropriate 
curves to the latter, but by developing the whole muscular system so that 
due support shall be given by nature. The deformities which come 
from this source are more frequent than is thought. Feeble, pale, quiet, 
over-dressed, a class of girls passes you, "filing" from room to room. 
You see one in a dozen with rosy cheeks, evidently a country girl. 
Their shoulders are all round, and they have the droop forward "which 
indicates a want of muscular vigor and deficient expansion of the chest. 
A part of the impression thus given may be due to the subdued tone and 
manner of the school-room. The same girls, however, "stay in at 
recess ;" they ride home in the horse-car ; their leisure is spent in piano 
practice, and in going to parties. 

There is a potent remedy for these evils in the hands of school boards : 
it is the practice of gymnastics. In this single measure the entire list of 
evils called "school maladies" is attacked by giving increased force to 
the entire physical system. Let pupils in normal schools be first made 
to appreciate the benefits of the system by applying it to them ; let them 
learn to discard sundry superfluities of dress, by being taught the com- 
forts of " gymnasium dress;" let plain sense, under the title of hygiene, 
be taught as more important than scientific physiolog}'. If this class of 
persons can be converted, a permanent benefit accrues to all their pupils 
m future. 

But to return to the subject of desks : 

3. In classes, however well graded, great differences of height are 
noticed. In accordance with this, each class-room in a graded school 
ought to have at least two sizes of desks ; three are desirable. 

4. Height of the desk. When the pupil sits upright, and the arms 
swing freely, the elbows will be just below the edge of the desk, and 
when bent in writing, will barely clear the edge. Girls require a desk 
from one half to three quarters of an inch higher. 

5. The edge of the desk must come up to a line just over the edge of 
the seat, or must overlap the seat by an inch or two. This keeps the 
child from stooping. 

Nos. 4 and 5 are of importance as tending to prevent deformity. Too 
high a desk raises the right or left shoulder undid}'. A desk at a dis- 
tance from the pupil's seat compels him to take a bad posture. 

What remains to be said of school gymnastics may be said here. A 



34 SCHOOL HYGIENE. 

good deal may be done with no apparatus at all in the ordinary class- 
room. Light gymnastics, comprising movements of the arms, are to be 
practised daily, more for the benefit of the change and for stimulating 
circulation than for development of body. An hour twice a week will 
suffice for a more thorough course, with a trained special teacher, in a 
room devoted to the purpose. No heavy apparatus is recommended, — 
light wands, dumb-bells of wood, perhaps small clubs. It has been found 
best for classes exercising together in the Amherst college gymnasium to 
give up the heavy gymnastics altogether ; much more so in schools. 
Then there are the " free exercises," including proper methods of sitting, 
standing, lying, walking, running, jumping, as well as exercises in con- 
cert, games, etc. 

"The aim of these free exercises is to call into action in turn the 
greater part of the voluntary muscles of the body ; and with an intelli- 
gent, earnest teacher to direct them, there is no end to the modifications 
and combinations that can be made, calling for precision, and strict at- 
tention, and skill on the part of pupils." 1 

A very valuable work can be done at once, with no special apparatus, 
and with comparatively little training, by heads of schools who have at 
command a spare room or a hall with movable seats. The members of 
upper classes can be instructed by him with perfect success in marching, 
facing, and a varietv of exercises of too complicated a nature to be car- 
ried on in the school-room. 

There are two present obstacles to the adoption of a complete system 
of training, — the expense, and the want of trained teachers. The calling 
of a gymnastic teacher, in fact, is a laborious one. But the matter is one 
of prime importance, especially in our city schools ; and teachers may 
aid materially in securing the adoption of a thorough system by trying 
to use the means now in their power. 



VII. AFFECTIONS OF THE NERVOUS SYSTEM. 

School life is capable of doing much good, as well as harm, to the 
mental and nervous life of scholars. Over-work, work performed under 
pressure or at bad seasons of the year, work done in a state of anxiety, 
are among the causes of injury. The influence of competition for prizes 
is acknowledged to be bad in a great many cases. 

" Double promotions" ought to be watched with care. 

As regards over-work, a change in public feeling has come about of 
late, which has largely led to the abandonment of home study for pupils 
under the age of (about) twelve years, and has cut down the hours of 
attendance at school to five in the day. One innovation of modern origin 
requires to be criticised, — the use of a single session, closing at i or 2 
p. M., instead of the morning and afternoon session. There should be 
one long recess in such a session, and arrangements for luncheon may 

1 Dr. J. J. Putnam. 



SCHOOL HYGIENE. 35 

enter with profit into the consideration of the school authorities, for it is 
unnatural for a growing youth or girl to fast six hours on a stretch amidst 
vigorous exertion of mind. The fact that some have no appetite for a 
lunch constitutes ground for suspecting that the school life or work is 
responsible for the want of appetite. 

It is a serious grievance of teachers and scholars that the time of year 
when the work is hardest is the spring and early summer, the seaso/ 
alike of review, examinations, diplomas, promotions, prizes, all cj 
which is made more trying by " spring sickness " and premature summer- 
heats. At the close of a year's work there should be an approach to 
relaxation of effort. How difficult it is to secure such a relaxation is 
well known to teachers. Many a teacher is ready to faint with fatigue 
before the welcome rest comes. The children do not now suffer so much, 
their work being rather irregular than severe, for the most part, at those 
times. 

On a matter so familiar to the public as mental over-work and strain 
among school-children, not a great deal need be said. It is probable 
that social dissipation does a great deal more harm than school work. 
Girls, of course, need more watching than bovs, for they more readily 
give up their habits of out-door exercise, and too often have no in-door 
work whatever to compensate for it. Even among 'eachers this fault is 
marked. Their toil is an anxious one, and they l'equire relaxation as 
much as any profession, but they too often fail to recognize the need. 
The writer was told by a prominent "kindergarten" teacher, who has 
teachers under her and instructs others in kindergarten work, that it is a 
frequent fault among her teachers, as well as her adult pupils, to suppose 
that they could work in the morning in teaching, attend a class in the 
afternoon, and go to parties in the evening, the fact being that in this 
kind of work no teacher ought to consider herself capable of any .serious, 
responsible undertaking outside of her kindergarten ; and the kindergarten 
hours are from nine to twelve o'clock ! 

Without doubt this is very near the truth. Teachers who have five 
hours' work a day are to be considered as having done a day's work. 
Seldom, however, is the work completed in that time, for under the new 
regime a great deal of work is written by the children, and has to be 
looked over and corrected at home by teachers. 

Among positive injuries to the system, and symptoms of injury, the 
following may be named as often due to school fatigue : 

Debility, want of appetite, dyspepsia, sleeplessness, irritability, head- 
ache. Other troubles, of less frequent occurrence, are menstrual anom- 
alies, irritable spine, hysteria, chorea, neuralgia. A case of epilepsy is 
known to the writer, which recurred after five years of health, in a vig- 
orous youth who overworked himself in competing for a prize va gym- 
nastics. 

Complaints peculiar to females have often been charged to the injury 
received in going up and down stairs. Derangement, including excess, 
painful periods, or deficiency, as well as local displacements, have been 



36 SCHOOL HYGIENE. 

noticed. It is certain that the existence of many flights of stairs is com- 
plained of, and that young women avoid rooms in the upper stories of 
boarding-schools in many cases. It maybe well to give here a summary 
of the evidence collected by Geo. E. Smith, M. d., in 1S74, in respect to 
a number of such institutions. The replies amount to the following, 
substantially : 

Ansvt'er No. 1. The complaints named are not usually prevalent: 
there are restrictions upon undue haste in going up or down stairs : 
should prefer to have no dormitories above the second story. 

2. They are very frequent, and are due to this cause. 

3. High buildings are bad if there is carelessness in running up and 
down, not otherwise ; improper dress and dissipation are the chief 
causes. 

4. Similar to 3. 

5. Rarely due to stairs ; due to dissipation : should prefer two-story 
buildings. 

6. Not due to stairs, but to lacing, heavy skirts, and over- work. 

7. Dress, corsets, and stair-climbing are far more to blame than study. 

8. Stairs are a great evil while girls are dressed as they are now. 
The matter has been touched upon in another division of this essay. 

VIII. CONTAGIOUS DISEASE IN SCHOOLS. 

The diseases intended by the title are diphtheria, scarlet fever, measles, 
and small-pox. 

There is little need to enfoi'ce by argument the importance of the sub- 
ject. There is a pretty general feeling that the matter of complaint is 
not an imaginary one. In the report of the Massachusetts State Board 
of Health (ninth) a large number of letters from physicians are cited or 
referred to, all, with scarcely an exception, acknowledging the danger of 
contagion to be real. There is, however, a mass of ignorance and blind- 
ness in the lower social strata which cannot be expected to pay the slight- 
est heed to ordinary precautions for preventing contagion until forced to 
do so. The means for bringing such heedless persons to their duty now 
exist in many places in the form of local ordinances or school regula- 
tions. Such regulations should be something like the following : 

1. The existence of a case of the above named diseases should exclude 
from school all inmates of the house in which it prevails, until compe- 
tent authority decides that it is safe for them to return to school. 

2. Teachers, school officers, or physicians should report cases coming 
to their knowledge at once, whether such cases are in their own school 
or not. The child affected is to be sent home at once, and the parents 
informed of the law. 

3. Contagion being easily spi - ead by pupils after recovery by means of 
clothing or fine particles of epidermis, etc., it is necessary to establish 
rules for disinfection, whether of the premises and clothing, or of the 
patient's body, the proper performance of such disinfection, and the lapse 
of a suitable time, being ascertained upon good authority. 



SCHOOL HYGIENE. 3/ 

4. Evidence of vaccination should be required of all children entering 
the public schools, and revaccination should be recommended to pupils 
at a later date, especially during epidemics of small-pox. 

Contagious affections of the skin, and spasmodic diseases (itch, scald 
head, ring-worm, epilepsy, St. Vitus's dance, habitual hysteric attacks) , 
are deserving of attention, as liable to occur at any time in a city schooh 
Teachers should have some knowledge of what is to be done in such 
cases, and should be authorized to complain to school governments. 
The convulsive affections named are, some of them, contagious through 
imitation, and must be excluded unless there seems good reason for the 
contrary course. 

IX. SANITARY SUPERVISION. 

As a corollary to all that has been said, we must consider how the 
facts can be made operative in and upon the schools. In many school 
boards, one person — or a committee — is charged with matters pertaining 
to the health of scholars. For most places this plan is the desirable one. 
In large places, including cities of all sizes, a natural means to this end 
is the appointment of one or more persons charged "with the enforcement 
of regulations based on sanitary principles. This plan will soon be 
tested thoroughly ; the only difficulty (or rather, the only question) seems 
to be in relation to the extent of the duties and functions of such officers. 

The cities of Elmira, N. Y., and Boston, Mass., each have an officer, 
a physician, who acts as medical supervisor. In the latter place he is 
entitled "Instructor in Hygiene," the peculiarity of the designation being 
due to certain technical difficulties in the local statutes. Here it may be 
truly said that the field for one man's exertions being unlimited, and far 
beyond any man's capacity to fill, it is open to the incumbent's discretion 
to select the most necessary objects for his first attention. At present 
the inspection of the buildings forms the leading object in Boston. In- 
struction in hygiene is also given by means of lectures addressed to teach- 
ers. That such an officer should be a physician requires no proof. 

How great the opportunity for work may be in certain cases is shown 
by that of the city of Brussels, which (for European ideas) presents a 
model in this respect. This city, with a population of 183,000 and thirty- 
three public schools, has a staff of medical visitors sufficient in number 
to make a weekly visit, with personal attention, to each pupil. In one 
respect their duties go beyond what is likely to be thought advisable in 
America at present, — they give medical treatment to a large number of 
pupils at school. The number thus treated for the three years i8j6-'jgt 
was 446, 732, 1,118, besides which, during the same three years, there 
were 2,885 cases of dental treatment. Among the chief duties of such 
an officer should be those of inspection of buildings, and of instruction of 
teachers in the principles of hygiene as applicable to their charges. San- 
itary rules may be proposed by him, and he will have a great opportu- 
nity of rectifying errors in sanitary administration due to mere ignorance. 
He will not take from members of the school board their right to be 



38 SCHOOL HYGIENE. 

interested, but he can greatly increase the interest if he knows how to 
use his knowledge of the subject. It need not be said that there are some 
points where the field is already occupied, as the matter of public vacci- 
nation, and other means for guarding against contagion — matters usually 
in the hands of town or city boards of health. Where these points are 
not thus arranged, the school inspector should have them in charge. 



STYLES AND PRICES: 

The four essays, in one volume of nearly two hundred 
large octavo pages, thoroughly indexed, printed upon 
extra heavy paper made especially for this edition, and 
bound in expensive brown cloth with gold and black 
finish, making an elegant and handsome volume. $ .75 
The same on lighter paper, well bound in cloth . . .50 

The four essays (four pamphlets) .25 

No. 1. Healthy Homes and Foods for the Working 

Classes .10 

Same in English-German (alternate pages in German) .15 
No. 2. Sanitary Needs and Necessities of School- 
Houses and School Life ... .05 

No. 3. Disinfection and Individual Prophylaxis against 

Infectious Diseases .05 

Same in English-German (alternate pages in German) .10 
No. 4. The Preventable Causes of Disease, Injury, and 
Death in American Manufactories and Workshops, 
and the Best Means and Appliances for Preventing 
and Avoiding Them .05 

These exceedingly valuable essays, written by authors of great ability, 
and selected, as the best out of many received in competition, by com- 
mittees of award whose names alone guarantee the high character of the 
works, are being placed before the public at cost, through means that 
are being furnishedMhe American Public Health Association ; and it is 
earnestly desired that departments, organizations, societies, manufacturers, 
and individuals assist in distributing these essays as extensivelv as pos- 
sible, for the good of all classes of society, especially the school children 
and the laboring classes. 

These works have been electrotyped and printed in large quantities, 
so that they can be furnished in any number, large or small, at the bare 
cost of paper, press-work, and binding. 

The essays, with the exception of the 75-cent edition and die English- 
German editions, in pamphlet form, are for sale at. the agencies of the 
American News Company. When not obtainable at such agencies, they 
may be had by forwarding the order to the Secretary of the American 
Public Health Association, Concord, N. II. 



TESTIMONIALS. 



The following are among the unsolicited endorsements already 
received : 

S. H. Durgin, Health Officer, Boston, Mass. : 

" The volume is full of valuable material worth double its price." 
Hon. Erastus Brooks, West New Brighton, N. Y. : 

" The prize essay volume is most excellent for the people and for all interested in the 
questions discussed. Compilation and publication are all that could be desired." 
Prof. R. D. Kedzie, M. D., Lansing, Mich. : 

"Am pleased with the appearance of the volume, and promise myself much pleasure in 
its perusal." 
S. A. Evans, M. D., Conway, N. H. : , 

" It seems to me very desirable that these essays should be in every family. Could not 
the substance of them be embodied in a school text-book and used in our schools ? If the 
young could be educated in the subject, it would be an excellent provision for the future." 
D. O. Smith, M. D., Hudson Centre, N. H. : 

" The work is invaluable to the rising generation, professional and otherwise." 
T. E. Sanger, M. D., Littleton, N. H. : 

"Think it ought to be in the hands of every board of health and of education." 
Nathan Allen, M. D., LL. D., Lowell, Mass. : 

"A most valuable work, especially the paper on American Manufactories and Work- 
shops." 
Ed. Wm. Germer, M.D., Pres. St. Bd. of Health, Erie, Penn. : 

" It is an excellent book, and ought to be translated into German and French and Swed- 
ish languages to reach the masses of the people." 
Prof. C. A. Lindsley, M. D., Sec'y St. Board of Health, New Haven, Conn. : 

" You have given us a capital volume. Some benevolent man of money ought to steer 
one into the family of every householder in the land." 
Crosby Gray, Esq., Health Officer, Pittsburgh, Penn. : 

"A most valuable work." 
L. W. Hubbard, M. U., Lyndon, Vt. : 

" I am much pleased with the volume, and hope to induce some of our citizens to send 
for it." 
W. A. Haskell, M. D.. Alton, 111. : 

" The work is in every respect a credit to the Association." 
L. H. Cohen, M. D., Quincy, 111. : 

" Book received in good condition. Expect to derive much pleasure and information 
from its careful perusal." 
Geo. M. Cox, M. D., member St. Bd. of Health, Springfield, Mo. : 

"I am highly delighted with the volume, and consider it a dollar well spent." 
C. W. Chancellor, M. D., Sec'y St. Bd. of Health, Baltimore, Md. : 

"A handsome and valuable volume." 



B. W. Palmer, M. D., Detroit, Mich. : 

I shall take pleasure in commending the volume to my medical friends. It is really 
unique in the thoroughness and practical suggestiveness of the important subjects dis- 
cussed." 

Albert L. Gihon, M. D., Medical Director U. S. N., Washington, D. C. : 

"In the publication of the Lomb Prize Essays the American Public Health Associa- 
tion has entered upon the practical stage of its work as the conservator of the public- 
health. I trust the admirable series of monographs thus initiated will be continued, until 
sanitary treatises of this high character may, through their cheapness, excellence, and 
attractiveness, be found among the household authorities in every part of the country." 
A. E. Winchell, M. D., member Board of Health, New Haven, Conn. : 

" Its perusal affords great pleasure. It should be in the hands of every physician and 
sanitarian." 
W. R. Speare, Esq., Washington, D. C. : 

" I am much pleased with it." 
F. F. Preston, M. D., New Haven, Vt. : 

" It is a volume of great value, and ought to be in every American home." 
Charles Ambrook, M. D., Boulder, Col. : 

" A very valuable work, and cheap." 
T. E. Miller, M. D., Westport, Ind. : 

" The more I read your book, the better I like it." 
H. C. Crowder, M. D., member St. Bd. of Health, Williams, Cal. : 

" I am very much pleased with the Lomb Prize Essays, and would earnestly recommend 
that a copy be in every public school library as well as in every physician's. I congratu- 
late you on your valuable book." 
Albert Merrell, M. D., St. Louis, Mo. : 

"The essays are valuable contributions to sanitary science, and should be widely circu- 
lated." 
A. E. Abrams, M. D., Collinsville, Conn. : 

" These essays will go very far toward enlightening all classes of citizens on the very 
important topics of which they treat." 
Chas. F. Wingate, C. E., New York city : 

" An admirable summary of facts clearly expressed, and suitable for popular enlighten- 
ment." 
Henry Shimer, M. D., Mt. Carroll, 111. : 

" I am glad that I concluded to send for the work. It is valuable for everybody." 
H. S. Orme, M. D., Pres. St. Bd. of Health, Los Angeles, Cal. : 

"The prize essays are excellent, and just what I wanted for reference." 
Editor Building, New York city : 

" Shall take pleasure in reviewing this interesting work, and possibly make extracts 
unless you object to our doing so." 
Walter F. Wells, Esq., Winthrop, Mass. : 

" I consider it a valuable book, and wish it was in every household." 
Gerrard G. Tyrrell, M. D.. Sec'y St. Bd. of Health, Sacramento, Cal. : 

"The volume is admirable, and wonderfully cheap." 



THE AMERICAN PUBLIC HEALTH ASSOCIATION, 

Organized in 1872 by a few eminent sanitarians, has grown in fourteen 
years to be the strongest and ablest association of its kind in America, 
if not in the world, and contains in its list of members, physicians, law- 
yers, clergymen, teachers, engineers, architects, and representatives of 
other trades and professions. Its influence has been felt in the legislative 
halls of the nation, as well as in every state and territory, for the amelio- 
ration of sickness and suffering, and the prolongation of human life. 

The eleven large and elegant volumes it has published are in them- 
selves a monument to American hygiene, while their precepts and 
teachings have been felt through all ranks and grades of society, from 
the workshop to the mansion of the millionaire. No library is complete 
in its literature of sanitation without these works. 

Each member of the Association receives a copy of the annual volume 
free of expense. This work alone is worth more to any individual than 
the cost of membership. 

Information relating to the Association, as well as blank applications 
for membership, may be obtained by addressing the Secretary, Dr. 
Irving A. Watson, Concord, N. H. 



EXTRACT FROM CONSTITUTION. Art. I If. 

The members of this Association shall be known as Active and Associate. The 
Executive Committee shall determine for which class a candidate shall be proposed. 
The Active members shall constitute the permanent body of the Association, subject to 
the provisions of the Constitution as to continuance in membership. They shall be 
selected with special reference to their acknowledged interest in or devotion to san- 
itary studies and allied sciences, and to the practical application of the same. The 
Associate members shall be elected with special reference to their general interest only in 
sanitary science, and shall have all the privileges and publications of the Association, 
but shall not be entitled to vote. All members shall be elected as follows : — 

Each candidate for admission shall first be proposed to the Executive Committee in 
writing (which may be done at any time), with a statement of the business or profession* 
and special qualifications, of the persons so proposed. On recommendation of a majority 
of the committee, and on receiving a vote of two thirds of the members present at a 
regular meeting, the candidate shall be declared duly elected a member of the Associa- 
tion. The annual fee of membership, in either class, shall be five dollars. 



